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STATE OF MONTANA

This is the minimum information required

(This space for use by the Secretary of State only)

AMENDED CERTIFICATE of AUTHORITY

of FOREIGN CORPORATION

APPLICATION

LINDA McCULLOCH

MAIL:

Secretary of State

P.O. Box 202801

Helena, MT 59620-2801

PHONE:

(406) 444-3665

FAX:

(406) 444-3976

WEB SITE:

sos.mt.gov

Required Filing Fee: $15.00

 24 Hour Priority Handling check box & Add $20.00

 1 Hour Expedite Handling check box & Add $100.00

For the purpose of amending its original application for certificate of authority with the State of Montana to transact

business or conduct affairs in Montana, according to

35-1-1029, MCA

(profit), or

35-2-823, MCA

(nonprofit), the

undersigned submits the following statements of fact to the Secretary of State and attaches an original, currently dated

Certificate of Existence duly certified and issued by the Secretary of State of the State of its jurisdiction with the Great

Seal affixed.

1. A certificate of authority was issued to the corporation by the Secretary of State of Montana on ________________

(Month/Day/Year)

2. Authorizing the entity to transact business or conduct affairs in Montana under the current name of

________________________________________________________________________________________________

If the document is hand written, please print legibly or the application may be denied

3. The corporate name has been changed to: ____________________________________________________________

If for profit, the name must contain “corporation”, “company”, “incorporated”, “limited”, or abbreviation of such.

4. Its period of duration has changed from: ______________________________ to: _____________________________

5. Its state or country of jurisdiction has changed from: ____________________ to: _____________________________

If the corporation was involved in a merger or consolidation, the name of the surviving corporation is:

________________________________________________________________________________________________

Both entities must be qualified

7. If a nonprofit corporation, its designation has changed from: ____________________ to: ______________________

Note: Must be a Public Benefit Corporation, Mutual Benefit Corporation or Religious Corporation.

8. “I, HEREBY SWEAR AND AFFIRM, under penalty of law, that the facts contained in this document are true.”

____________________________________________________________________ __________________________

Signature of Officer or Chairman of the Board

Date

_________________________________________________

Title

Daytime Contact: Phone _______________________ Email ______________________________________________

sos.mt.gov/Business/Forms

65-Amended_Certificate_of_Authority_of_Foreign_Corporation.doc

Revised: 11/09/2011

Amended Certificate Of Authority Of Foreign Corporation Application - Montana Secretary Of State

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